Maine dental board challenges oral sedation safety

The Maine Board of Dental Examiners (MBDE) has come under fire for proposed rule changes that would, among other things, require general dentists to use heart monitors on patients who choose to undergo moderate oral sedation for dental procedures.

Opponents say the proposed changes would set dentistry in Maine back 10 years and put a financial burden on dentists, according to news reports. The state says it is a matter of public safety.

"The Maine Board of Dental Examiners is considering a range of possible rule changes," said Doug Dunbar, assistant to the commissioner of the Maine Department of Professional and Financial Regulation, in an e-mail to "All changes were suggested in the interest of public safety."

Oral conscious sedation has been allowed in Maine for more than a decade, according to Daniel Steinke, D.D.S., an officer with the Maine Academy of General Dentistry (MAGD). The ADA recently reaffirmed the efficacy and safety of oral conscious sedation when administered in accordance with its guidelines. The electrocardiogram recommendation being proposed by the MBDE, however, is not part of the ADA guidelines.

"The MAGD has been following this sedation case for three years," said Dr. Steinke, who heads the MAGD committee on oral conscious sedation. "All the state board needs to do is accept the ADA guidelines. But what they've done instead, against the MAGD committee recommendations and public pressure, is rewrite the whole rule from beginning to end."

In fact, it is unclear what prompted the board to propose the rule changes. No adverse incidents have resulted from moderate sedation in Maine, according to Dr. Steinke.

"I've been doing it in my practice for 28 years," he said. "It is very safe."

If the MBDE decides to go with the proposed rule changes, Maine would become the only state in the U.S. to require patients to wear heart monitors during moderate oral sedation.

"Why is the state of Maine more dangerous than anywhere else?" Dr. Steinke said. "Why do we need to be the most restrictive and regulated state?"

The proposed rule changes will be publicly debated September 12 in Augusta. Written comments will be accepted until October 9, 2008. The MBDE is expected to react and respond to all oral and written comments pertaining to the proposed rule changes during its October 10, 2008, meeting.

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